Hospice and Palliative Medicine Fellows' Perspectives on Physician-Assisted Dying Education.

Abstract

Physician-assisted dying (PAD) is legal in a growing number of U.S. states, with access expanding nationally due to recent legislative changes. Despite this, how to address PAD in hospice and palliative medicine (HPM) fellowship programs remains undefined. The perspectives of HPM fellows regarding PAD education have not been studied. To assess HPM fellows' experiences and interest in a formal PAD curriculum, including preferred content areas and anticipated relevance to future practice. An anonymous nine-item survey was sent to all HPM fellows (N = 21) at the Icahn School of Medicine at Mount Sinai. Survey domains included prior exposure to PAD, attitudes toward PAD education, and intention to provide PAD in future clinical practice. The response rate was 100%. Most fellows (81%) had no formal education on PAD. All respondents agreed that learning about PAD in fellowship is important. Topics of interest included ethical considerations (95%), legal criteria (86%), responding to requests in serious illness conversations (86%), navigating requests (76%), and pharmacology/modes of ingestion (71%). A majority (62%) were interested in an away elective with a PAD provider. While only 10% intended to provide PAD in future practice, 57% were unsure or had not thought about it, and 33% were not considering it. Fellows unanimously supported including PAD education in HPM training, regardless of intent to participate in the practice. These findings underscore a clear educational need and may guide curriculum development. To our knowledge, this is the first survey assessing HPM fellows' views on PAD.